Does traumatic dental injury impact oral health-related to quality of life of children and adolescents? Systematic review and meta-analysis.

Abstract

This systematic review aimed to evaluate the association of traumatic dental injury (TDI) on oral health-related to quality of life (OHRQoL) in children and adolescents. A focused structured question using Population (P), Exposition (E), Comparisons (C), Outcomes (O) (PECO) was designed: "Does traumatic dental injury impact OHRQoL of children and adolescents?" A broad search according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was conducted. Evaluation criteria of methodological quality and risk of bias control were applied to selected articles. A fixed-effect model was used for the meta-analysis, and the quality of the evidence was performed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Nineteen studies were qualified with moderate to high quality, and 11 studies were considered for meta-analysis. Negative impact on OHRQoL was detected for children in the symptoms domain (P=.005; IC; -0.07 [-0.12, -0.02]) with moderate certainty of evidence quality level (GRADE). For adolescents, the total scale and all domain presented statistical significance (P<.05) with moderate certainty of evidence in the areas of functional limitation and social well-being (GRADE). Based on articles with moderate to high quality, the impact of TDI on OHRQoL in children under age 10 was only significant in the symptom domain using Early Childhood Oral Health Impact Scale (ECOHIS). The impact of TDI on OHRQoL in early adolescents aged 11 to 14 was significant in every assessed domain using Child Perception Questionnaire (CPQ11-14). However, future studies should be done improving the available certainty of evidence considered moderate. (CRD42016035686).